Reasons why pituitary tumors are easily misdiagnosed

Because the clinical symptoms of pituitary tumors are not very typical, they are more likely to be misdiagnosed. Some of the symptoms caused by its onset can often be caused by other diseases. Therefore, there is a certain misdiagnosis rate in clinical practice, leading to delayed treatment. So, what are the reasons why pituitary tumors are easily misdiagnosed? Let's take a look.

Pituitary tumors are common benign adenomas with an incidence of 1/100,000 to 7/100,000, accounting for about 10% of all intracranial tumors, and there has been an increasing trend in recent years. Pituitary adenomas can produce different symptoms due to different types, sizes and growth directions, but they are mainly in the two aspects of endocrine abnormalities and neurological dysfunction. For elderly patients whose body functions are in the decline stage, their metabolic levels are low, their responses to changes in the internal environment are slow, and their symptoms do not change significantly, resulting in the failure to timely detect and clearly diagnose pituitary tumors. In addition, pituitary tumors are easily misdiagnosed, which is also related to the following reasons.

Causes of misdiagnosis of pituitary tumors: atypical clinical manifestations

The manifestations of pituitary tumors are complex and varied, and difficult to distinguish, especially the lack of specific symptoms for non-secreting adenomas. Non-secreting adenomas can affect the secretion of gonadotropin, thyroid-stimulating hormone, and adrenocorticotropic hormone, causing fatigue, lethargy, loss of appetite, mental depression, hyponatremia, hypoglycemia, and weakness.

The body functions of the elderly decline, and specific symptoms are not prominent. Disease symptoms are often misdiagnosed as other diseases by non-specialist doctors. Non-functioning adenomas are more common in the elderly population, accounting for more than half of pituitary tumor patients. Therefore, especially for the middle-aged and elderly population, it is important to distinguish the symptoms of non-functioning adenomas from those of coronary heart disease and other diseases.

The second reason for misdiagnosis of pituitary tumors is that the primary and secondary symptoms are not clearly distinguished

Take a typical case as an example. The patient presented with "loss of appetite, fatigue, palpitation, shortness of breath, chest tightness, and chest pain", and then was found to have hyponatremia. The symptoms involve multiple systems of the body. Analysis of the causes shows that loss of appetite causes fatigue, but it cannot explain the heart symptoms such as palpitation and shortness of breath at the same time. After a comprehensive analysis, it was concluded that hyponatremia can cause loss of appetite, increased heart rate, chest tightness, and chest pain. However, it is still different from the symptoms of heart disease. Therefore, the chest tightness and chest pain experienced by this patient cannot be used as the basis for an independent diagnosis of coronary heart disease. Therefore, the main cause and symptom of "hyponatremia" should be grasped to explain a series of clinical phenomena that occur in patients.

Misdiagnosis of pituitary tumors: Hyponatremia is not investigated in depth

Taking the above patient as an example, he had anorexia and fatigue 4 months ago, and repeatedly had emergency reactions of aggravated diseases caused by colds. At the same time, the patient has diabetes, and it cannot be simply assumed that diabetic nephropathy causes increased sodium loss through the kidneys, resulting in hyponatremia, while ignoring the abnormal changes in blood sodium in the elderly due to other diseases. At the same time, the sensory factors of the patient's main complaint should be excluded, and the influence of the patient's mental factors should be excluded, so as not to mislead the doctor's diagnosis and treatment judgment.

Reasons for misdiagnosis of pituitary tumors: four: incorrect selection of auxiliary examinations

Choosing appropriate auxiliary examinations is very helpful for correct clinical diagnosis. For the diagnosis of pituitary tumors, CT examination results are not as clear as MRI, especially in the detection of microadenomas. Similar case reports: no abnormalities were found after pituitary CT examination, while cranial MRI showed that the pituitary gland was significantly enlarged, resulting in enlarged sella turcica and sunken sella turcica. The pituitary gland was about 1.8cm×1.5cm×1.6cm. This shows that MRI is more reliable in providing a basis for the diagnosis of pituitary tumors.

In general, due to the diversity of symptoms of pituitary tumors, they are easily misdiagnosed.